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Na Hong Wei
Orthopedics
About me
Yanshou County People's Hospital, Orthopedics Department, Chief Physician, engaged in clinical work in orthopedics for many years.
Proficient in diseases
Specializes in: Orthopedics, general surgery, and minimally invasive treatment.
Voices
Do benign osteomas require surgery?
Does a benign osteosarcoma require surgery? First, it needs to be clarified that there is no such thing as a benign osteosarcoma; osteosarcomas are definitely malignant and their degree of malignancy is relatively high. According to the Enneking staging, they are classified as Stage IIB and are highly prone to distant metastases, such as lung and brain metastases. Therefore, if osteosarcoma is described as benign, the first point is that it is a diagnostic error—it is not osteosarcoma; the second point is a misunderstanding, as osteosarcoma only has malignant forms. Additionally, how should osteosarcoma be treated? Currently, there is a treatment called neoadjuvant chemotherapy, which involves 6-8 sessions of chemotherapy before surgery. After the symptoms subside and the tumor size reduces, the specific circumstances of the patient determine whether conservative or timely treatment is chosen, followed by continued chemotherapy after surgery. This approach helps significantly improve the five-year and ten-year survival rates of osteosarcoma patients. Therefore, it is important to note two points: first, osteosarcoma is not benign but malignant; second, the current treatment for osteosarcoma mainly revolves around surgical combined treatment methods.
How should one sleep with sciatica?
Sciatica is a very painful condition. Paying attention to some details when resting and sleeping can alleviate sciatica to a certain extent. Specifically, the first point is to sleep on a hard bed, preferably a solid wooden bed. If the bed is too soft, consider placing a wooden board on it. Second, lying on your back is better than lying on your side. This is because lying on your back can maintain the stability of the lumbar spine, thereby reducing the pressure on the discs. Third, maintain a moderate flexion of the hips and knees while sleeping. To do this, place a small soft pad under the lower back and a small soft pillow under the knee joints to keep the hip joints in a slightly flexed position. The purpose is to let the muscles of the lower back relax optimally, thus stabilizing the lumbar spine and reducing the burden on the lumbar discs. Therefore, for sciatica, if you sleep on a harder bed in a supine position, and maintain proper knee and hip flexion, it can be very beneficial for recovery.
How is osteoporosis diagnosed?
How to check for osteoporosis? Currently, in clinical practice, there is no single instrument or technology that can definitively determine whether you have osteoporosis. Therefore, the examination for osteoporosis involves measuring bone density and bone markers, or combining these two methods to achieve a joint diagnosis. What is the gold standard for bone density measurement? It is DXA, which stands for Dual-Energy X-ray Absorptiometry. Through the measurement of this instrument, a Z-score and T-score will be obtained, among which the T-score is mainly used as the diagnostic indicator, while the Z-score is primarily considered for differential diagnosis. Secondly, bone markers are tested, and large hospitals, especially tertiary hospitals, perform this test very well. So, if you suspect that you have osteoporosis and want to know what tests to take? These two tests would be sufficient.
Dietary taboos for osteoporosis
Dietary therapy for osteoporosis is an important treatment method. First, eat foods that are high in calcium. Second, consume high protein diets; third, moderately supplement vitamins. Avoid high-salt diets, because the main component of salt, sodium chloride, affects bone metabolism. Sodium chloride primarily increases the excretion of calcium, meaning that higher levels of sodium chloride lead to higher levels of calcium excretion. Therefore, high sodium diets can increase the amount of calcium excreted in urine; excessive intake of sodium chloride can lead to further loss of calcium. Thus, it is essential to focus on a low-sodium diet.
Which department is for lumbar disc herniation?
The meaning is which department to visit for lumbar disc herniation. If going to a hospital for lumbar disc herniation and if there is a spinal surgery department, the first choice should be the spinal surgery department. If there is no spinal surgery department, then you can visit the general orthopedics department. If it's an acute episode of severe pain due to lumbar disc herniation, and you want to address the pain issue, you can visit the pain management department. The pain management department has unique methods for treating sciatica caused by lumbar disc herniation, and the treatment results are very good. If it's a chronic lumbar disc herniation, and you need some rehabilitative treatment or physiotherapy, you can also visit the rehabilitation department or the physiotherapy department. In summary, for lumbar disc herniation, you should first visit the spinal surgery department, then the general orthopedics, visit the pain management department if addressing pain, and go to rehabilitation if seeking recovery.
How to treat rib fractures and pneumothorax?
The most significant complication of an acute rib fracture is pneumothorax, often seen in traffic accidents, such as when an airbag deployment causes barotraumatic injury to the chest, or directly from a vehicular collision that breaks the ribs and causes air leakage from the lungs. The leaked air from the lung compresses it by accumulating in the chest cavity. In cases of pneumothorax, if it is severe, it is essential to go to the hospital. The treatment involves a doctor performing a closed chest drainage procedure, which practically means inserting a tube at the midclavicular line of the second intercostal space. One end of this tube is inserted into the chest cavity, while the other end connects to a negative pressure drainage bottle. After the surgery, the gas in the chest cavity is expelled directly into the drainage bottle and then out of the bottle, effectively resolving the issue. Therefore, for the treatment of pneumothorax caused by rib fractures, firstly, one must go to the hospital and consult thoracic surgery; secondly, the doctor performs a minor procedure, closed chest drainage, to expel the air from the chest cavity. After observing for a period to ensure no further leakage and good lung expansion, the drainage tube can be clamped off. After two to three days of observation, the tube can be removed, which successfully treats the pneumothorax.
Does osteoporosis hurt?
The clinical manifestations of osteoporosis include three main points. The first is pain, thus osteoporosis will definitely cause pain. This pain may be localized or it may be widespread. The second is spinal deformation, which can result in forward bending of the spine, scoliosis, or even spinal shortening, which is a reduction in height. The third point is pathological fractures, which are characteristic of osteoporosis. These fractures occur due to insufficient bone strength caused by osteoporosis, and sometimes even low energy or minor external forces can cause fractures, such as pulling a door or being struck by a car door. Therefore, osteoporosis definitely involves pain, and pain is one of the main symptoms of osteoporosis.
Is there a cure for bone metastasis of osteosarcoma?
Is there any hope for osteosarcoma bone metastasis? If osteosarcoma develops bone metastasis, there is still hope for treatment. However, once metastasis occurs, the treatment costs, difficulty, and prognosis tend to be relatively unfavorable. Additionally, osteosarcoma itself invades and damages the bone. As the disease progresses, it stimulates osteogenesis which eventually leads to both bone formation and damage. Generally, the appearance of osteogenic changes often indicates a shift towards a better prognosis for the bone. Therefore, if osteosarcoma has metastasized, while treating the primary lesion of the tumor, it is also crucial to actively treat the metastatic sites. Thus, the difficulty of the treatment and the prognosis might not be very optimistic, but it certainly hasn't reached a point where the disease is untreatable. Therefore, once osteosarcoma metastasizes, it is recommended to visit the oncology department of a reputable hospital for systematic treatment by a doctor.
Does osteoporosis cause pain?
Osteoporosis can be painful, and the clinical manifestations of osteoporosis are threefold: first, pain; second, vertebral deformation; third, fragile fractures. Pain is the earliest symptom of osteoporosis, which can be localized pain, generalized pain, aching pain, or dull pain. Therefore, for older individuals or women around the time of menopause, if there is unexplained pain, and no primary or secondary lesions can be found, osteoporosis should be considered. In fact, the examination for osteoporosis is quite simple. Currently, the most commonly used clinical examinations are radiological and biochemical tests. In radiological tests, DXA, which stands for Dual-energy X-ray Absorptiometry, is the gold standard for clinical diagnosis. In addition, some bone markers can be tested, making diagnosis fairly straightforward. Therefore, osteoporosis can be painful, and if there is unexplained generalized pain in conjunction with age and gender, osteoporosis should be considered.
Treatment methods for lumbar muscle strain
Firstly, some non-surgical treatments, namely conservative treatments, should be carried out. The majority of patients can see significant relief in their symptoms after conservative treatment, and some of them may even be cured. Conservative treatment begins with general treatment. Primarily, it involves bed rest after the onset of lumbar muscle strain symptoms, ceasing work, and minimizing bending activities. Additionally, wearing a lumbar support is advised to prevent further injury. Secondly, it is appropriate to exercise the muscles of the lower back. If the strength of these muscles is increased, not only can it enhance the stability of the lumbar spine, but it can also reduce pressure inside the intervertebral discs and delay the aging and degeneration of the spine. Thirdly, physical and rehabilitation therapies should be employed. This mainly includes traction, physiotherapy, massage, acupuncture, and external application of traditional Chinese medicine. The goal is primarily to relax spasmodic back muscles. At the same time, it can alleviate pressure within the intervertebral discs and reduce the inflammation around the nerve roots. Fourthly, if the pain is extremely severe and significantly affects everyday life and work, consideration may be given to taking non-steroidal anti-inflammatory pain medications, along with muscle relaxants. This can result in very effective pain relief. If the outcome of standardized conservative treatment is unsatisfactory, surgical treatment can be considered. However, for lumbar muscle strain, non-surgical treatment is generally preferred, with only a few patients requiring surgery.